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Interferon Gamma Release Assays for the Diagnosis of Latent TB Infection in HIV-Infected Individuals in a Low TB Burden Country

BACKGROUND: Interferon gamma release assays (IGRAs) are used to diagnose latent tuberculosis infection. Two IGRAs are commercially available: the Quantiferon TB Gold In Tube (QFT-IT) and the T-SPOT.TB. There is debate as to which test to use in HIV+ individuals. Previous publications from high TB bu...

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Autores principales: Ní Cheallaigh, Clíona, Fitzgerald, Ian, Grace, Jacinta, Jagjit Singh, Gurmit, El-Eraki, Nahla, Gibbons, Noel, Keane, Joseph, Rogers, Thomas R., Clarke, Susan, Bergin, Colm
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3559731/
https://www.ncbi.nlm.nih.gov/pubmed/23382842
http://dx.doi.org/10.1371/journal.pone.0053330
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author Ní Cheallaigh, Clíona
Fitzgerald, Ian
Grace, Jacinta
Jagjit Singh, Gurmit
El-Eraki, Nahla
Gibbons, Noel
Keane, Joseph
Rogers, Thomas R.
Clarke, Susan
Bergin, Colm
author_facet Ní Cheallaigh, Clíona
Fitzgerald, Ian
Grace, Jacinta
Jagjit Singh, Gurmit
El-Eraki, Nahla
Gibbons, Noel
Keane, Joseph
Rogers, Thomas R.
Clarke, Susan
Bergin, Colm
author_sort Ní Cheallaigh, Clíona
collection PubMed
description BACKGROUND: Interferon gamma release assays (IGRAs) are used to diagnose latent tuberculosis infection. Two IGRAs are commercially available: the Quantiferon TB Gold In Tube (QFT-IT) and the T-SPOT.TB. There is debate as to which test to use in HIV+ individuals. Previous publications from high TB burden countries have raised concerns that the sensitivity of the QFT-IT assay, but not the T-SPOT.TB, may be impaired in HIV+ individuals with low CD4+ T-cell counts. We sought to compare the tests in a low TB burden setting. METHODOLOGY/PRINCIPAL FINDINGS: T-SPOT.TB, QFT-IT, and tuberculin skin tests (TST) were performed in HIV infected individuals. Results were related to patient characteristics. McNemar’s test, multivariate regression and correlation analysis were carried out using SPSS (SPSS Inc). 256 HIV infected patients were enrolled in the study. The median CD4+ T-cell count was 338 cells/µL (range 1–1328). 37 (14%) patients had a CD4+ T-cell count of <100 cells/µL. 46/256 (18% ) of QFT-IT results and 28/256 (11%) of T-SPOT.TB results were positive. 6 (2%) of QFT-IT and 18 (7%) of T-SPOT.TB results were indeterminate. An additional 9 (4%) of T-SPOT.TB results were unavailable as tests were not performed due to insufficient cells or clotting of the sample. We found a statistically significant association between lower CD4+ T-cell count and negative QFT-IT results (OR 1.055, p = 0.03), and indeterminate/unavailable T-SPOT.TB results (OR 1.079, p = 0.02). CONCLUSIONS/SIGNIFICANCE: In low TB prevalence settings, the QFT-IT yields more positive and fewer indeterminate results than T-SPOT.TB. Negative results on the QFT-IT and indeterminate/unavailable results on the T-SPOT.TB were more common in individuals with low CD4+ T-cell counts.
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spelling pubmed-35597312013-02-04 Interferon Gamma Release Assays for the Diagnosis of Latent TB Infection in HIV-Infected Individuals in a Low TB Burden Country Ní Cheallaigh, Clíona Fitzgerald, Ian Grace, Jacinta Jagjit Singh, Gurmit El-Eraki, Nahla Gibbons, Noel Keane, Joseph Rogers, Thomas R. Clarke, Susan Bergin, Colm PLoS One Research Article BACKGROUND: Interferon gamma release assays (IGRAs) are used to diagnose latent tuberculosis infection. Two IGRAs are commercially available: the Quantiferon TB Gold In Tube (QFT-IT) and the T-SPOT.TB. There is debate as to which test to use in HIV+ individuals. Previous publications from high TB burden countries have raised concerns that the sensitivity of the QFT-IT assay, but not the T-SPOT.TB, may be impaired in HIV+ individuals with low CD4+ T-cell counts. We sought to compare the tests in a low TB burden setting. METHODOLOGY/PRINCIPAL FINDINGS: T-SPOT.TB, QFT-IT, and tuberculin skin tests (TST) were performed in HIV infected individuals. Results were related to patient characteristics. McNemar’s test, multivariate regression and correlation analysis were carried out using SPSS (SPSS Inc). 256 HIV infected patients were enrolled in the study. The median CD4+ T-cell count was 338 cells/µL (range 1–1328). 37 (14%) patients had a CD4+ T-cell count of <100 cells/µL. 46/256 (18% ) of QFT-IT results and 28/256 (11%) of T-SPOT.TB results were positive. 6 (2%) of QFT-IT and 18 (7%) of T-SPOT.TB results were indeterminate. An additional 9 (4%) of T-SPOT.TB results were unavailable as tests were not performed due to insufficient cells or clotting of the sample. We found a statistically significant association between lower CD4+ T-cell count and negative QFT-IT results (OR 1.055, p = 0.03), and indeterminate/unavailable T-SPOT.TB results (OR 1.079, p = 0.02). CONCLUSIONS/SIGNIFICANCE: In low TB prevalence settings, the QFT-IT yields more positive and fewer indeterminate results than T-SPOT.TB. Negative results on the QFT-IT and indeterminate/unavailable results on the T-SPOT.TB were more common in individuals with low CD4+ T-cell counts. Public Library of Science 2013-01-30 /pmc/articles/PMC3559731/ /pubmed/23382842 http://dx.doi.org/10.1371/journal.pone.0053330 Text en © 2013 Ni Cheallaigh et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Ní Cheallaigh, Clíona
Fitzgerald, Ian
Grace, Jacinta
Jagjit Singh, Gurmit
El-Eraki, Nahla
Gibbons, Noel
Keane, Joseph
Rogers, Thomas R.
Clarke, Susan
Bergin, Colm
Interferon Gamma Release Assays for the Diagnosis of Latent TB Infection in HIV-Infected Individuals in a Low TB Burden Country
title Interferon Gamma Release Assays for the Diagnosis of Latent TB Infection in HIV-Infected Individuals in a Low TB Burden Country
title_full Interferon Gamma Release Assays for the Diagnosis of Latent TB Infection in HIV-Infected Individuals in a Low TB Burden Country
title_fullStr Interferon Gamma Release Assays for the Diagnosis of Latent TB Infection in HIV-Infected Individuals in a Low TB Burden Country
title_full_unstemmed Interferon Gamma Release Assays for the Diagnosis of Latent TB Infection in HIV-Infected Individuals in a Low TB Burden Country
title_short Interferon Gamma Release Assays for the Diagnosis of Latent TB Infection in HIV-Infected Individuals in a Low TB Burden Country
title_sort interferon gamma release assays for the diagnosis of latent tb infection in hiv-infected individuals in a low tb burden country
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3559731/
https://www.ncbi.nlm.nih.gov/pubmed/23382842
http://dx.doi.org/10.1371/journal.pone.0053330
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